Social Class and Prognosis in Coronary Heart Disease

Abstract

The relationship between social class and prognosis was studied in 299 successive men under 60 years who survived a first attack of acute coronary heart disease (CHD). Indices of prognosis included risk-factors, return to work and 3-year mortality. Occupation was used as the index of social class.

Risk-factors were uniformely distributed in the different social groups at entry to the study. Over 3 years a highly significant association was noted between social class and risk-factor changes. Cigarette smoking, level of exercise and weight showed a significant improvement in the higher social classes.

90 % of patients had returned to work after one year. While lower special classes were significantly slower in returning to work there was no significant relationship between social class and re-employment.

The 3-year mortality was not influenced by social class despite the difference in risk-factor changes.

It is concluded that an independent influence of social class on return to work and on mortality is not apparent. However, further study is needed to determine the effect of poor compliance on subsequent morbidity and mortality.